Pulmonary complications of hyperventilation therapy for persistent pulmonary hypertension

Abstract

Hyperventilation has become a primary therapeutic modality in the management of neonates with persistent pulmonary hypertension (PPH). Of 51 PPH infants undergoing hyperventilation therapy, 45% developed pneumothorax. The subgroup which developed pneumothorax was exposed to assisted ventilation for significantly longer time periods and at higher peak inspiratory pressures. They were also exposed to longer periods of oxygen therapy at higher oxygen concentrations. Survival in the pneumothorax group was significantly lower. The incidence of bronchopulmonary dysplasia (BPD) in the 35 survivors was only 6%. These data indicate that the use of hyperventilation to treat PPH is associated with a significant incidence of pneumothorax but a low incidence of BPD.